Conservation Laryngectomy

In the standard total laryngectomy operation for laryngeal cancer the whole larynx is removed so that the patient is left with a permanent tracheostoma. Although many patients later attain satisfactory cesophageal voice, some do not and the operation results in a significant physical handicap. The aim of conservation surgery is to excise only part of the larynx so that normal laryngeal function is preserved and a tracheostoma avoided. The two principle conservation operations are supraglottic partial laryngectomy, for supraglottic tumours, and vertical hemilaryngectomy, for glottic tumours. In supraglottic partial laryngectomy all laryngeal tissues above the level of the vocal cords are removed this comprises the false cords, the aryepiglottic folds, the epiglottis, the preepiglottic space, the upper parts of the thyroid laminr and the hyoid bone. In vertical hemilaryngectomy the vocal cord, the arytenoid cartilage, the false cord and the adjacent thyroid cartilage are removed from one side of the larynx. Various extensions of these basic procedures have been described, but in spite of this the procedures